Inspection on 24/11/05 for Hillingdon House

This inspection was carried out on 24th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hillingdon House 29/07/08

Hillingdon House 22/01/08

Hillingdon House 13/03/07

Hillingdon House 24/11/04

Hillingdon House 21/06/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Hillingdon House 31 Salisbury Road Farnborough Hampshire GU14 7AJ Lead Inspector Debbie Oliver Unannounced Inspection 24th November 2005 09:30a Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hillingdon House Address 31 Salisbury Road Farnborough Hampshire GU14 7AJ 01252 542148 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Regard Partnership Limited Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users are only to be accommodated between 18 and 65 years Date of last inspection 20th June 2005 Brief Description of the Service: Hillingdon House provides care to younger adults, who have learning disabilities and complex needs Service users are given help with all aspects of their lives but are encouraged to be as independent as possible. There are nine bedrooms, a kitchen, lounge, dining room and laundry facilities. Additionally the home has a conservatory backing on to a large garden creating more communal space. Hiilingdon House is situated in a residential area, close to the main shopping centre in Farnborough. The home is close to public transport as well as having its own transport. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over four hours and during the visit both the manager, the service users and the staff on duty assisted with the inspection. An opportunity was taken to look around the home, view some records, talk to staff and spend some time with service users. Due to the nature of the service user’s disabilities it was quite difficult to talk to all of them but observation enabled the inspector to gain a better understanding of how the needs of some service users were being met and two service users was talked to throughout the day. The inspector also received four questionnaires from relatives and five from service users who were assisted by staff to complete. At the previous unannounced visit on 20th June 2005 the home was issued with six requirements, four of which were outstanding from the previous inspection. Progress has been made to meet the six requirements, however one remains outstanding and a further two have been given on this visit. Since the last inspection the home has now appointed a permanent manager who is currently going through the registration process. What the service does well: What has improved since the last inspection? The complaints procedure has been updated so service users can access this if they have concerns or worries. The plans are improving to ensure sufficient information about individuals is available to staff so they support them appropriately. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 6 Service users now have the relevant information ensuring they can make an informed decision about where they live. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 5 Service users have the relevant information ensuring they can make an informed decision about where they live. Each contract must contain the necessary information to inform service users of their rights within the home. EVIDENCE: Since the last inspection all the relevant information has been included within the statement of purpose including whether nursing care is provided, the fire precautions and associated emergency procedures in the home, number and size of rooms and details of any therapeutic techniques used in the home. This allows service users to know what they can expect from the service. The service user’s guide also has a copy of the complaints procedure so service users have the information should they have any concerns or complaints about the service. At the last inspection a requirement was made stating all contracts must include rooms to be occupied, fees charged and who pays these, costs of services and what the fees cover. The manager confirmed this has not happened; this has been a requirement for the third inspection and must be actioned. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 There is a clear and consistent care planning system being put in place to adequately provide staff with the information they need to satisfactorily meet all service user’s needs but more work is needed when restrictive techniques are being used. Service users are fully supported to make decisions in all areas of their lives. Risk assessments are in place and ensure service users are able to take risks as part of an independent lifestyle. EVIDENCE: Since the last inspection individual plans of care are available and three were sampled. They now give detailed information on assessed and changing needs and personal goals and it is now showing clearly what support individuals require. There are still some plans that have not been fully updated and these will be reviewed at the next visit. It was discussed with the manager that when a service user is using bed rails the documentation needs to be in place as to why this is necessary and the agreement of all involved must be reached. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 10 A new member of staff spoken to said they found the care plans and risk assessments really useful when getting to know an individual. Service users spoken to said they are supported to make decisions about their lives including what they do during the day and what they wear. Risk assessments are now in place and show that service users are supported to take risks. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14, 15 and 17 Service users generally have opportunities to engage in suitable activities to meet their needs with good relations and support from friends and families. Service users are offered plenty of fresh food with lots of choices to enable a balanced and healthy diet. EVIDENCE: On the day of the inspection some service users were accessing day services, and some were out with their support workers. One service user refused to attend college and preferred to stay at home. There are two service users who are not currently engaging in regular activities but staff support them to access the community as much as possible. However new staff are about to start working in the home and once they have received the necessary training the activities for these two individuals will be a priority. Service users spoken to said they have regular contact with family members and friends. One service user said they see their family every week. Staff spoken to also said families keep in touch by telephone. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 12 The inspector viewed the menu for the week and this showed a variety of food offering a healthy diet for service users and the staff member spoken to said the menu is always looked at to ensure a balanced diet is available although alternatives are there as needed. On the day of the inspection one service user was helping staff to prepare lunch. There have been some issues relating to one service user being on a diet for a significant period of time. In discussion with the Doctor it has been decided a healthy eating plan is devised and the diet stopped for the time being. Service users spoken to said they liked the food offered and are not given foods they don’t like. Fresh fruit and vegetables were seen during the visit. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 20 Service user’s health and personal needs are being met to ensure they are supported in the way they prefer although further work is required to ensure the correct procedures are in place in relation to medication to further protect service users. EVIDENCE: Since the last inspection the plans are much more detailed giving staff more information to support individuals appropriately. It was discussed with the manager and staff on duty that more specific information is needed in some care plans about the support individuals require with personal support. The medication policy was viewed and is clear and easy to use. The medication is in blister packs and is coloured coded to show at what times medication should be given. It was discussed with the manager the documentation to show how much ‘as required’ medication has been given does not correlate with the running total and staff must be reminded to record when this medication has been administered. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 14 All staff have received the relevant training and the paperwork for this was seen by the inspector. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Arrangements for protecting service users and responding to concerns are satisfactory. EVIDENCE: Since the last inspection the complaints procedure has been updated to reflect the name of the Commission and the relevant address details. The role of the Commission is clearly recorded on the procedure and this will also be discussed at the next team meeting. The home now has the relevant documentation relating to adult protection including the whistle blowing procedure, the adult protection policy and the ‘no secrets’ guidance. Additionally staff spoken to were clear what to do in the event of an allegation of abuse being reported to them and have received the necessary training. Since the last inspection the new manager and deputy of the home are signatories for six people living in the home and families are responsible for the other people living in the home. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 A comfortable and safe standard of accommodation is provided for the service users, which meets their needs. EVIDENCE: The home is well maintained and suited to the service users needs. It is decorated and furnished to a standard that creates a comfortable and homely ambience. It was discussed with the manager that four bedroom doors and the upstairs and downstairs bathroom doors were not shutting properly. Additionally the cupboard opposite one upstairs bedroom was open but stated ‘fire door keep locked’. The manager agreed to action this. The laundry facilities remain unsuitable for the purpose. It is situated in the garage and staff have to go out of the building to access it in all weathers. The laundry floor is not impermeable and the walls not readily cleanable. It was discussed that as a long term plan this should be addressed. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 Service users are supported by an effective staff team with further work happening to recruit more staff. EVIDENCE: The majority of the staff team have worked in the home for some years with lots of experience supporting people with learning disabilities. There are some issues relating to recruiting staff and this was an issue in the questionnaires received from relatives to the Commission. The manager has recently recruited a fulltime staff member and a bank staff who is also a driver. The recruitment drive is ongoing but it is not always possible that staff who are suitable to work in the home can also drive. Families have raised concerns about staffing levels but every effort is being made and there is also a permanent advert in the local job centre. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The home is managed efficiently and service users benefit from a well run home. Service users views are sought to ensure they are involved in the selfmonitoring, reviewing and development of the home. The health, safety and welfare of service users is fully promoted with staff being well trained and showing a sound knowledge within the areas of health and safety. EVIDENCE: Since the last inspection the home now has a permanent manager who is currently undergoing the registration process. The home is starting to incorporate quality assurance in to the home. There are senior meetings to discuss any issues and concerns and regulation 26 visits are undertaken monthly and a copy of the report is sent to the Commission. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 19 Additionally the manager is organising a Christmas party. All families and friends are invited as a chance for any issues to be discussed. One service user spoken to said they would go to the manager if they had any problems. The fire risk assessment is not completed and the manager agreed this would be made a priority. Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X X 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hillingdon House Score 3 X 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000011866.V251616.R01.S.doc Version 5.0 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA5 Regulation 5(1)(c) Requirement The registered person must ensure the necessary information is included in the contract between the service user and registered provider. (THIS IS AN OUTSTANDING REQUIREMENT FROM THE LAST INSPECTION.) The registered person must ensure the relevant documentation is in place when using bed rails. The registered person must ensure staff sign when they have administered ‘as required’ medication Timescale for action 24/01/06 2 YA6 12(3) 24/02/06 3 YA20 13(2) 24/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hillingdon House DS0000011866.V251616.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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